Individual
PATRICIA ELLEN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA ., LPCC
Contact information
Practice address
11 CALLE MEDICO STE 5, SANTA FE, NM 87505-4705
(505) 577-2959
Mailing address
PO BOX 5887, SANTA FE, NM 87502-5887
(505) 577-2959
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0075291
NM
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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